目的：探讨糖尿病视网膜病变血清miR-146a与核转录因子-κB(NF-κB)和血管内皮生长因子(VEGF)的相关性。

方法：选取2016-07/2017-12我院收治的2型糖尿病患者100例为研究对象，合并DR患者32例(DR组)，未合并DR患者68例(T2DM组)。选取同期体检的健康志愿者30例作为对照组。采用real-time PCR检测血清miR-146a，采用酶联免疫法检测NF-κB和VEGF，分析miR-146a与NF-κB和VEGF的相关性。

结果：与对照组比较，T2DM组和DR组HbA1c升高(t=6.822、5.709，均P<0.001)，空腹血糖(FBG)升高(t=8.889、7.923，均P<0.001)，餐后2h血糖(2h PBG)升高(t=6.646、5.514，均P<0.001)。与T2DM组比较，DR组糖尿病病程较长(t=2.431， P=0.017)。与对照组比较，T2DM组和DR组血清miR-146a明显降低(t=3.967、7.169，均P<0.001)，且DR组低于T2DM组(t=4.444，P<0.001)。与对照组比较，T2DM组和DR组血清NF-κB明显增加(t=6.063、14.851，均P<0.001)，VEGF明显增加(t=7.613、12.943，均P<0.001)； 且DR组NF-κB和VEGF大于T2DM组(t=11.406、7.560，均P<0.001)。Pearson分析显示miR-146a与NF-κB和VEGF呈负相关(r=-0.503、-0.574，P<0.05)。

结论：DR患者血清miR-146a明显降低，NF-κB和VEGF明显增加，miR-146a有可能通过介导炎症反应和血管增生参与DR的发病。

METHODS: A total of 100 patients with T2DM treated in our hospital from July 2016 to December 2017 were assigned into T2DM patients with DR(DR group, n=32)and T2DM patients without DR(T2DM group, n=68). Thirty healthy volunteers were selected as control group. Real-time PCR was used to examine the expression of miR-146a. Enzyme linked immunosorbent assay was used to detect the levels of NF-κB and VEGF. The correlation between miR-146a and NF-κB and VEGF was analyzed.

RESULTS: Compared with the control group, HbA1c in T2DM group and DR group increased(t=6.822, 5.709; P<0.001), FBG increased(t=8.889, 7.923; P<0.001), 2hPBG increased(t=6.646, 5.514; P<0.001). Compared with T2DM group, the duration of diabetes in DR group was longer(t=2.431, P=0.017). Compared with the control group, serum miR-146a in T2DM and group DR significantly decreased(t=3.967, 7.169; P<0.001), and the DR group was lower than that in the T2DM group(t=4.444, P<0.001). Compared with the control group, the serum NF-κB in the T2DM and DR group increased significantly(t=6.063, 14.851; P<0.001), VEGF increased significantly(t=7.613, 12.943; P<0.001), NF-κB and VEGF in DR group were larger than those in T2DM group(t=11.406, 7.560; P<0.001). Pearson analysis showed that miR-146a was negatively correlated with NF-κB and VEGF(r=-0.503, -0.574; P<0.05).

CONCLUSION: The serum miR-146a in DR patients significantly decreased, the NF-κB and VEGF significantly increased. MiR-146a may be involved in the pathogenesis of DR by mediating inflammatory reaction and vascular proliferation.